Individual provider Active NPI

Harikrishna Bandla, MBBS

  • Internal Medicine Physician
  • Monroe, LA
National Provider Identifier
1104336460
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
324405 Issued in LA
Practice address
309 Jackson St
Monroe, LA 71201-7407
Phone
(318) 966-4541
Fax
(318) 966-4543
NPI assigned
Oct 1, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 324405 LA Primary

Addresses

Primary practice location

309 Jackson St
Monroe, LA 71201-7407

Mailing address

309 Jackson St
Monroe, LA 71201-7407
Phone (318) 966-4541

Other practice location 1

254 Easton Ave
New Brunswick, NJ 08901-1766
Phone (732) 745-8600

Other identifiers 2

IdentifierTypeStateIssuer
058669OtherLACDS
324405OtherLASTATE LICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address hbandla1528785@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201001000240 LA Practitioner - Internal Medicine 8325467913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Francis Medical Group LLCGroup PAC ID 5092970624, 176 clinicians

Practice addresses (Care Compare)

309 Jackson St
Monroe, LA 71201-7407
Phone (318) 966-4541

Hospital & facility affiliations

  • Fmol Health St Francis Hospital, Monroe, LA, CCN 190125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
324405LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Medical Group LLC Internal Medicine CurrentSince Oct 15, 2020 Accepting new patients
St Francis Medical Center, Inc Past Accepting new patients
St Francis Medical Center, Inc Past Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

517 Catalpa St
Monroe, LA 71201
Phone (318) 966-6500

1805 Jackson St
Monroe, LA 71202
Phone (318) 651-0041

309 Jackson St
Monroe, LA 71201
Phone (318) 966-4000

Networks

  • LA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: hbandla1528785@direct.casso.us.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1104336460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 JACKSON ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017407",
            "telephone_number": "318-966-4541",
            "fax_number": "318-966-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 JACKSON ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017407",
            "telephone_number": "318-966-4541",
            "fax_number": "318-966-4543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "254 Easton Ave",
            "address_purpose": "LOCATION",
            "city": "New Brunswick",
            "state": "NJ",
            "postal_code": "089011766",
            "country_code": "US",
            "telephone_number": "732-745-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANDLA",
        "first_name": "HARIKRISHNA",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-01",
        "last_updated": "2023-03-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "324405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS",
            "identifier": "058669",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "324405",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hbandla1528785@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "hbandla1528785@direct.casso.us.com",
            "address_1": "309 Jackson St",
            "city": "Monroe",
            "state": "LA",
            "country_code": "US",
            "postal_code": "712017407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "309 Jackson St",
            "city": "Monroe",
            "state": "LA",
            "country_code": "US",
            "postal_code": "712017407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.